Pregnancy outcomes following hospitalisation for a fall in Washington State from 1987 to 2004.

OBJECTIVE

To evaluate the risk of adverse maternal and perinatal outcomes among pregnant women hospitalised following falls.

DESIGN

A population-based retrospective cohort study.

SETTING

Washington State, USA.

POPULATION

Pregnant women with a fetal death or live birth certificate linked to the hospitalisation discharge data from 1987 to 2004.

METHODS

Pregnant women who experienced a fall (n = 693) were identified by the presence of an International Classification of Disease-9th Edition external causation code of E880 through E888 and were compared with a randomly chosen group of pregnant women (n = 2079) not experiencing a fall hospitalisation during pregnancy. Poisson regression analysis was used to estimate adjusted relative risks (RR) and 95% CI for associations between falls and pregnancy outcomes.

MAIN OUTCOME MEASURES

Preterm labour and delivery, placental abruption, fetal distress, and fetal hypoxia.

RESULTS

This study found an incidence rate of 48.9 pregnant fall hospitalisations per 100 000 deliveries. The majority of the fall hospitalisations occurred in the third trimester (79.3%), with 11.3% in the second trimester and 9.4% in the first trimester. The majority of injuries due to falls were fractures (47.4%), especially of the lower extremity, followed by contusions (18.0%) and sprains (17.3%). Falls were associated with an increased risk of preterm labour (RR 4.4, 95% CI 3.4-5.7), placental abruption (RR 8.0, 95% CI 4.3-15.0), fetal distress (RR 2.1, 95% CI 1.6-2.8), and fetal hypoxia (RR 2.9, 95% CI 1.3-6.5).

CONCLUSION

In light of the increased risk of adverse maternal and perinatal outcomes associated with major falls resulting in hospitalisation, careful maternal and fetal monitoring following a major fall is warranted.